Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 111NS0005X | Chiropractic Sports Physician | 01964 | MD |
Y | 111NX0800X | Chiropractor Orthopedic Specialist | 01964 | MD |
NPI | 1689781809 |
---|---|
Provider Name | Michael E Barvinchack |
First Address | Hagerstown, MD 21742-1438 |
Second Address | Hagerstown, MD 21742-1438 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/08/2006 |
Last Update Date | 07/05/2009 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
U82852 | (02) | MD |